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Patient-Reported Outcomes (PROs) and PRO Remission Rates in 12,262 Biologic-Naïve Patients With Psoriatic Arthritis Treated With Tumor Necrosis Factor Inhibitors in Routine Care

Ørnbjerg, Lykke M. ; Rugbjerg, Kathrine ; Georgiadis, Stylianos ; Rasmussen, Simon H. ; Jacobsson, Lennart ; Loft, Anne G. ; Iannone, Florenzo ; Fagerli, Karen M. ; Vencovsky, Jiri and Santos, Maria J. , et al. (2024) In Journal of Rheumatology 51(4). p.378-389
Abstract

Objective. To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. Methods. Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire–Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. Results. For the first TNFi, median pain... (More)

Objective. To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. Methods. Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire–Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. Results. For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund Efficacy Index (LUNDEX)–adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 24%, 31%, 36%, and 43% (first TNFi); 14%, 19%, 23%, and 29% (second TNFi); and 9%, 14%, 17%, and 20% (third TNFi), respectively. For biologic-naïve patients with disease duration < 5 years, 6-month LUNDEX-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 22%, 28%, 33%, and 42%, respectively. Corresponding rates for patients with disease duration > 10 years were 27%, 32%, 41%, and 43%, respectively. Remission rates were 33%, 40%, 45%, and 56% for men and 17%, 23%, 24%, and 32% for women, respectively. For patients aged < 45 years at diagnosis, 6-month LUNDEX-adjusted remission rate for pain was 29% vs 18% for patients ≥ 45 years. Conclusion. In 12,262 biologic-naïve patients with PsA, 6 months of treatment with a TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, disease duration, sex, and age at onset of disease were observed, emphasizing the potential influence of factors other than disease activity on PROs.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, fatigue, pain, psoriatic arthritis, tumor necrosis factor inhibitors
in
Journal of Rheumatology
volume
51
issue
4
pages
12 pages
publisher
Journal of Rheumatology Publishing Company Limited
external identifiers
  • scopus:85189795030
  • pmid:38224992
ISSN
0315-162X
DOI
10.3899/jrheum.2023-0764
language
English
LU publication?
yes
id
347a0403-784e-4c78-97ed-41ada68b000f
date added to LUP
2024-04-23 15:05:37
date last changed
2024-06-18 20:08:21
@article{347a0403-784e-4c78-97ed-41ada68b000f,
  abstract     = {{<p>Objective. To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. Methods. Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire–Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. Results. For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund Efficacy Index (LUNDEX)–adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 24%, 31%, 36%, and 43% (first TNFi); 14%, 19%, 23%, and 29% (second TNFi); and 9%, 14%, 17%, and 20% (third TNFi), respectively. For biologic-naïve patients with disease duration &lt; 5 years, 6-month LUNDEX-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 22%, 28%, 33%, and 42%, respectively. Corresponding rates for patients with disease duration &gt; 10 years were 27%, 32%, 41%, and 43%, respectively. Remission rates were 33%, 40%, 45%, and 56% for men and 17%, 23%, 24%, and 32% for women, respectively. For patients aged &lt; 45 years at diagnosis, 6-month LUNDEX-adjusted remission rate for pain was 29% vs 18% for patients ≥ 45 years. Conclusion. In 12,262 biologic-naïve patients with PsA, 6 months of treatment with a TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, disease duration, sex, and age at onset of disease were observed, emphasizing the potential influence of factors other than disease activity on PROs.</p>}},
  author       = {{Ørnbjerg, Lykke M. and Rugbjerg, Kathrine and Georgiadis, Stylianos and Rasmussen, Simon H. and Jacobsson, Lennart and Loft, Anne G. and Iannone, Florenzo and Fagerli, Karen M. and Vencovsky, Jiri and Santos, Maria J. and Möller, Burkhard and Pombo-Suarez, Manuel and Rotar, Ziga and Gudbjornsson, Bjorn and Cefle, Ayse and Eklund, Kari and Codreanu, Catalin and Jones, Gareth and van der Sande, Marleen and Wallman, Johan K. and Sebastiani, Marco and Michelsen, Brigitte and Závada, Jakub and Nissen, Michael J. and Sanchez-Piedra, Carlos and Tomšič, Matija and Love, Thorvardur J. and Relas, Heikki and Mogosan, Corina and Hetland, Merete L. and Østergaard, Mikkel}},
  issn         = {{0315-162X}},
  keywords     = {{epidemiology; fatigue; pain; psoriatic arthritis; tumor necrosis factor inhibitors}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{4}},
  pages        = {{378--389}},
  publisher    = {{Journal of Rheumatology Publishing Company Limited}},
  series       = {{Journal of Rheumatology}},
  title        = {{Patient-Reported Outcomes (PROs) and PRO Remission Rates in 12,262 Biologic-Naïve Patients With Psoriatic Arthritis Treated With Tumor Necrosis Factor Inhibitors in Routine Care}},
  url          = {{http://dx.doi.org/10.3899/jrheum.2023-0764}},
  doi          = {{10.3899/jrheum.2023-0764}},
  volume       = {{51}},
  year         = {{2024}},
}